Blake Lee Gowen, R.PH.

Primary specialty

PharmacistTaxonomy code 183500000X

License

12808 Issued in AL

Practice address

1207 Medical Dr SE
Decatur, AL 35601-4330

Phone

(256) 353-5011

Fax

(256) 355-5152

NPI assigned

Jan 31, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sand Drug Inc

  • Community/Retail Pharmacy
  • Decatur, AL
  • NPI 1154461200
  NPD (past) Authorized official
• Sand Drugs Inc

  • Durable Medical Equipment & Medical Supplies
  • Decatur, AL
  • NPI 1154354181
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982741401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 MEDICAL DR SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356014330",
            "telephone_number": "256-353-5011",
            "fax_number": "256-355-5152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 MEDICAL DR SE",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356014330",
            "telephone_number": "256-353-5011",
            "fax_number": "256-355-5152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOWEN",
        "first_name": "BLAKE",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "R.PH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AL",
            "license": "12808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Liane Goodpastor, CRNP
• Beronica Goodwin
• Kareen Vincent Goodwin, DPH
• Kathy S Goodwin, MS
• Jennifer Grace Gourlay, DMD
• Grace Health and Wellness Family Clinic
• Gregory Neal Graham, LPC
• Kaitlyn Kibbe Graham, CRNP
• Laura Ann Graham, CRNP
• Grand Oaks Counseling, LLC

• Pharmacist in Decatur, AL
• Providers in Decatur, AL by specialty
• Pharmacist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.